Background Serious illness disrupts the narrative coherence central to maintaining our sense of self. In healthcare interactions, including palliative medicine consultations, paying close attention to patient narrative provides insight into the multi-dimensional impact illness has on the whole person, and can be therapeutic; helping a person make sense of their illness and engage in narrative repair. Co-construction of narrative in consultation reflects a shared understanding of a patient's problems and a plan for future action that is collaborative. This literature review is the first step in a study to develop and evaluate a narrative-based approach for palliative medicine consultations following the Medical Research Council guidance on development and evaluation of complex interventions.
Aim To describe the scope and effectiveness of narrative interventions with patients in healthcare.
Methods Literature was sought from three electronic databases, hand-searching of journals, citation lists and on recommendations. Sources include all types of papers from peer-reviewed journals and textbooks published in English that describe narrative practice in healthcare and evaluate narrative interventions with adult patients in healthcare settings.
Results Of 1884 references initially identified 222 sources were included in the review. These were sorted into three categories: 1. Narrative theory applied in healthcare; 2. Biographical interventions; 3. Narrative therapy.
Conclusions The application of narrative theory in healthcare has grown since the 1980s, has broad scope, and includes many different interventions with patients few of which have been evaluated. Biographical interventions in gerontology however predate this more general interest, and with regards to life review therapy have demonstrated benefit in emotional well-being and life satisfaction for older people. Life review interventions such as Dignity Therapy have been successfully adapted for use in palliative care.
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